Last month, the Tennessee House of Representatives approved a resolution that denounces the U.S. Supreme Court’s decision in Obergefell v. Hodges, which legalized same-sex marriages across the country, including in Tennessee. Ongoing debate and pending legislation in the Tennessee legislature allows and potentially promotes discrimination against lesbian, gay, bisexual and transgender Tennesseans in public accommodations like locker rooms and restrooms, schools and universities, and health care settings.

For example, bills advancing through the Tennessee legislature would allow mental health counselors and therapists to deny health-related services to gay and transgender Tennesseans based on religious beliefs. Other bills would reject same-sex marriages, establish natural marriage between one man and one woman, and prohibit public officials from performing marriages and only permit that authority to religious leaders.

Unfortunately, these bills, among other anti-gay and anti-transgender legislation, are potentially harmful to the health of lesbian, gay, bisexual and transgender Tennesseans. Numerous public health studies have demonstrated that institutional and policy-based discrimination causes harm and leads to substantial health disparities. Discriminatory environments and public policies create stigma and provoke feelings of rejection, shame and low self-esteem among lesbian, gay, bisexual and transgender Americans.

A study in the American Journal of Public Health found that lesbian, gay and bisexual adults living in states, like Tennessee, without laws protecting them from hate crimes or discrimination in employment were more likely to report anxiety disorders, post-traumatic stress disorder and persistent depression compared to their peers living in states with protections against hate crimes or employment-based discrimination.

State laws that recognize and value lesbian, gay, bisexual and transgender families and individuals are associated with improved health outcomes. Two studies — one in California, the other in Massachusetts — found legalizing same-sex marriage was associated with reductions in psychological distress, mental health visits and mental health care costs among lesbian, gay and bisexual residents in those states.

Meanwhile, Tennessee’s proposals may also be harmful to children and young adults who are lesbian, gay, bisexual or transgender. Several public health studies have reported that gay high school students living in states with laws protecting gay and transgender people from discrimination, attending schools with gay-straight alliances or schools with anti-bullying policies in place, were less likely to be bullied or cyberbullied, attempt suicide, drink heavy levels of alcohol or smoke cigarettes. Thus, maintaining diversity-promoting organizations on school campuses is absolutely fundamental.

There are several possible options for Tennessee lawmakers to consider. First, lawmakers could reverse course. Instead of considering laws that promote discrimination, lawmakers should extend the fair and legal protections to lesbian, gay, bisexual and transgender persons, including protections from discrimination in employment, housing, education, public accommodations and health care settings. Each of these steps can reduce institutional discrimination and possibly lead to improvements in health and well-being in gay and transgender populations. However, should anti-gay and anti-transgender bills pass through the Tennessee legislature, Gov. Bill Haslam should consider vetoing such harmful discriminatory proposals.

Finally, policymakers should consider assisting researchers with learning more about the health needs of lesbian, gay, bisexual and transgender Tennesseans by adding questions on sexual orientation and transgender identity to statewide health surveys, including important health assessments used to monitor the health of adolescents and adults living in the state. Several neighboring states have started collecting health information from their gay and transgender residents, but the unique health needs of Tennessee’s lesbian, gay, bisexual and transgender population will remain invisible as long as sexual orientation and transgender identity are missing from prominent health surveys.

Despite these shortfalls, the damages to health associated with anti-gay and anti-transgender laws cannot be overlooked. These health issues should always be highlighted as debates continue in the legislative chambers, election contests and state courtrooms.